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Appendix 1
General Ethical
Principles for Potential
Cyber Art Therapists
(Art Therapy and Computer
Technology, C. Malchiodi, 2000,
Jessica Kingsley Publishers)
Note: These recommended principles not only provide historical background on the ethics of digital technology and social media, but also form a framework for contemporary ethical questions and challenges in using new media in art therapy practice.
In addition to online confidentiality, electronic storage, disposition of digital images, and other issues of ethics with regard to computer technology, there are a few other general points that the potential “cyber art therapist” should consider. These include, but are not limited to, the following:
1. Obtain a basic reference about the Internet and programs you plan to use. If you plan to use computer technology in your work, you will find that you need to stay current in your working knowledge of computer technology, just as you would do with ethics, legal issues, and practice issues relevant to your work.
2. Establish a philosophy about your plan to use computer technology for therapeutic purposes. If you integrate computer technology into your practice it is important that you consider how you personally see it as useful to the therapeutic process and how clients can benefit from this type of interaction or experience. Competence is necessary not only in computer or digital technology, but also in text-based communication. Style and knowledge of how to communicate with people through e-mail is intrinsic to the quality of online exchange.
3. Be sure to tell clients about the reservations of online therapy. What you do not like about computers and e-communication is as important as identifying the benefits of this technology.
4. Experiment with various components of computer, electronic, and digital technology yourself. It is now possible to get supervision from some people who are using this technology and material on competencies for telehealth and telemedicine are available. Peer supervision with other therapists interested in this area of work is also an option.
5. Consider the research on computer-mediated communication and therapy. For example, one study concluded that a greater use of the Internet might be associated with declines in people’s communication with family members, decreases the size of their social circle, and increases depression (Kraut et al., 1998). But others have observed the use of computer-mediated communication for social skill building and increased social networks, and that the Internet has made possible a global community. Computers have been successfully used to enhance already existing communities, such as neighborhoods, schools, and support groups (Michaelson, 1996). Research on computer-based counseling and therapy is extremely limited at present; outcome research on the use of art therapy via the computer is non-existent.
6. Explore the less tangible issues of cyber art therapy. For example, does overexposure to this type of technology make children less creative because it essentially “seduces” them away from hands-on activities such as art making (Kramer et al., 1995)? Are there diversity and socioeconomic issues involved, such as equal access or cultural preferences? Although many professions, including those in healthcare, require that one be proficient in navigating the digital world, access or right to the Internet has not been universal due to socioeconomic factors and other influences. This obviously raises questions about those who do not have the privilege of access to this technology and those who do.
Consider when computer technology can be culturally appropriate and helpful in treatment and communication. Earlier in this book I related my experience of using e-communication with a group of teens at a homeless shelter. Computers, along with video games and other electronic media, are part of the language and day-to-day life of increasing numbers of adolescents, but adults as well. For that particular group of adolescents, Internet communication was an effective way to engage them with a therapist.
7. Don’t be quick to judge online therapy too harshly. Be open to how technology can benefit your practice, as well as its disadvantages and drawbacks.
References
Kramer, E., Gerity, L., Henley, D. and Williams, K. (1995, November) Art and art therapy and the seductive environment. Panel presented at the 26th annual conference of the American Art Therapy Association, San Diego, CA.
Kraut, R., Lundmark, V., Patterson, M., Kiesler, S. and Scherlis, T. (1998) Internet paradox: A social technology that reduces social involvement and psychological well-being? American Psychologist 53(9), 1017–1031.
Michaelson, K. (1996) Information, community, and access. Social Sciences Computer Review 14(1), 57–59.
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Appendix 2
Sections of the Art
Therapy Credentials
Board (ATCB) Code of
Ethics, Conduct and
Disciplinary Procedures
that address digital
communication
and social media
[reprinted with permission of ATCB]
2.9.1 Art therapists must inform clients of the benefits, risks, and limitations of using information technology applications in the therapeutic process and in business/billing procedures. Such technologies include but are not limited to computer hardware and software, faxing, telephones, the Internet, online assessment instruments, and other technological procedures and devices. Art therapists shall utilize encryption standards within Internet communications and/or take such precautions to reasonably ensure the confidentiality of information transmitted, as in 2.9.5.6.
2.9.2 When art therapists are providing technology-assisted distance art therapy services, the art therapist shall make a reasonable effort to determine that clients are intellectually, emotionally, and physically capable of using the application and that the application is appropriate for the needs of clients.
2.9.3 Art therapists must ensure that the use of technology in the therapeutic relationship does not violate the laws of any federal, provincial, state, local, or international entity and observe all relevant statutes.
2.9.4 Art therapists shall seek business, legal, and technical assistance when using technology applications for the purpose of providing art therapy services, particularly when the use of such applications crosses provincial, state lines or international boundaries.
2.9.5 As part of the process of establishing informed consent, art therapists shall do the following:
2.9.5.1 Inform clients of issues related to the difficulty of maintaining the confidentiality of electronically transmitted communications, and the difficulty in removing any information or imagery that has been posted electronically if consent is later revoked.
2.9.5.2 Inform clients of all colleagues, supervisors, and employees (including Information Technology [IT] administrators) who might have authorized access to electronic transmissions.
2.9.5.3 Inform clients that, due to the nature of technology assisted art therapy, unauthorized persons may have access to information/art products that clients may share in the therapeutic process.
2.9.5.4 Inform clients of pertinent legal rights and limitations governing the practice of a profession across state/provincial lines or international boundaries.
2.9.5.5 Inform clients that Internet sites and e-mail communications will be encrypted but that there are limitations to the ability of encryption software to help ensure confidentiality.
2.9.5.6 When the use of encryption is not possible, art therapists notify clients of this fact and limit electronic transmissions to general communications that are not client specific.
2.9.5.7 Inform clients if and for how long archival storage of transaction records are maintained.
2.9.5.8 Discuss the possibility of technology failure and alternate methods of service delivery.
2.9.5.11 If a client wishes to access insurance coverage for technology-assisted distance art therapy services, art therapists shall advise clients that it is the client’s responsibility to confirm coverage before beginning services.
2.9.5.12 Inform clients that communication will be included in client documentation as mentioned in 2.7.3.
2.9.6 Art therapists maintaining sites on the Internet shall do the following:
2.9.6.1 Regularly check that electronic links are working and professionally appropriate.
2.9.6.2 Provide electronic links to the ATCB and other relevant state, provincial, and or international licensure and professional certification boards to protect consumer rights and facilitate addressing ethical concerns.
2.9.6.3 Strive to provide a site that is accessible to persons with disabilities
2.10.1 Art therapists wh...
